@helenbevan

The biggest ever day of collective action to improve healthcare that

started with a tweetHelen Bevan

Chief Transformation Officer,NHS Horizons Team

@helenbevan@NHSChangeDay #NHSChangeDay

@helenbevan #NHSChangeDay

The largest simultaneous improvement initiative in the history of the NHS

@helenbevan #NHSChangeDay

Emerging themes in large scale change

Organisation Community

Power through hierarchy Power through connection

Mission and vision Shared purpose

Making sense through rational argument

Making sense through emotional connection

Leadership-driven (top down) innovation

Viral (grass-roots driven) creativity

Tried and tested, based on experience

“ Open” approaches , sharing ideas & data, co-creating change

Transactions Relationships

Dominantapproach

Emerging direction

@helenbevan #NHSChangeDay

A polarity (not either/or)

@helenbevan #NHSChangeDay

John Kotter: “Accelerate!”• Many change agents, not just the usual few • A “want-to” - not just a “have-to” - mind-set

The spirit of volunteerism - the desire to work with others for a shared purpose – creates the energy to power the network

• Head and heart, not just headPeople won’t want to do a day job in the hierarchy and a night job in the network if we appeal only to logic with numbers, contracts and business cases

• The network AND the organisation

@helenbevan #NHSChangeDay

The Network Secrets of Great Change AgentsJulie Battilana andTiziana Casciaro

Place in the

network

Bridge networks

versus cohesive networks

As a change agent, my

centrality in the informal network is a

far more important

factor than my position in the formal hierarchy

Change agents who bridge

disconnected groups/individuals

more likely to deliver big change

Change agents with cohesive networks

more likely to deliver minor incremental

changes

@HelenBevan #NHSChangeDay

What’s our approach to change?

Deficit based

•what is wrong?•solve problems•identify what we need to improve•fill gaps and deficiencies

Strength based

•what is strong?•work with our existing assets and resources•amplify what works•“positive deviants”

@HelenBevan #NHSChangeDay

We possess power

“Our problem is to hitch it up for action on the broadest, daring and most gigantic scale”

Source: Kaiser Permanente LMP,

April 2012

@HelenBevan #NHSChangeDay

@HelenBevan #NHSChangeDay

We need to be boatrockers!• Walk the fine line between

difference and fit, inside and outside, rock the boat but manage to stay in it

• Able to challenge the status quo when we see that there could be a better way

• Conform AND rebel• Capable of working with others

to create success NOT a destructive troublemaker

Source: Debra Meyerson

@HelenBevan #NHSChangeDay Source : Lois Kelly www.foghound.com

Sometimes leaders see radicals as troublemakers

@HelenBevan #NHSChangeDay

Valuing radicals

• “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)

• big things only happen in organisations because of heretics and radicals

Its started with a tweet!

Young clinical leaders and improvement leaders started to talk about how they could improve care

Damian RolandStuart Sutton Helen Bevan

Did we have a strategy?

Yes but not this kind… This kind…

NHS Change Day - A call to action

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A 189,000 pledge mountain!

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Anyone can join in NHS Change Day

Social media played a very significant role in mobilising for Change day

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Example pledge – Ashley’s story Patient/Staff champion > to Board

Change day gave me permission to use my energy in the direction that I wanted to use it“”

Example pledge – Damian’s storyIndividual

I was surprised at how simple it actually was to do…“”

Example pledges• I pledge to show that we can all get through distress & suicidal thoughts - there

is hope/help via http://www.connectingwithpeople.org/ucancope’ Connecting with People, in partnership with the Royal College of Psychiatrists and many supporters

• I pledge to make my work colleagues feel supported and valued. To remind them of the great jobs they are doing everyday

• I pledge to take part in Tea 4 two - sitting with a patient on a regular basis who doesn’t have visitors and enjoy a cup of tea and a chat

• As a nurse I pledge to say thank you to the healthcare assistant I work with; asking her what more I can do to support her in her work .

• I will 're-humanise' my practice of medicine by always using patients' names when talking about them as a constant reminder of individuality

• We pledge to switch off the electronic notice board: we will all personally welcome and ‘meet & greet’ our patients from the waiting room

• We pledge to create a weekly opportunity for all staff to ask the question “what have I done to help a patient this week?”

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Big lessons from NHS Change Day 20131. Change happens one person at a time but if we can create common purpose, we can quickly build a movement

2. Being a leader is about choosing to be a leader and not waiting for those with positional power to tell you what to do

3. Being a leader in the NHS isn’t related to hierarchy or position; and you don’t even have to work in the NHS to qualify as a healthcare leader

4. When front line staff stepped up to the leadership opportunity offered by NHS Change Day, we found that most healthcare organisations actually valued these behaviours, rather than resisted them

5. There were some outstanding senior leader role models from NHS Change Day who showed us that leaders are at their most powerful as role models when they learn, rather than when they teach or tell

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6. Resources for change are abundant but they need to be activated, through shared purpose and relationships

7.Young leaders really do have a lot of the answers. Positional leaders need to create the conditions to support them and let them get on with it

8. The NHS has an outstanding (often latent) force of leaders everywhere in its ranks. The potential is there to liberate that army of leaders, to deliver the outcomes and experiences that our patients deserve and to build the continuous learning and improvement system that will make the English NHS the safest and best healthcare system in the world.

9. Through our “leaders everywhere”, we can protect and preserve the basic principles of our NHS for future generations

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Big lessons from NHS Change Day 2013

The postscript: NHS Change Day 2014

• Increase the reach to 500,000 pledges• Pledge, share, do and inspire framework• Inaugurate School of Healthcare Radicals• Kickstarter challenge• Mobile first approach underpinned by social media

and industrial-strength infrastructure• Discussions with colleagues in 16 territories globally• Launch on 6th November 2013

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@HelenBevan

Our core leadership team

@HelenBevan

Probably the only winner of a global challenge

to develop leaders in the

corporate world that names Saul

Alinsky and Marshall Ganz

as major influencers

@HelenBevan

....the last era of management was about how much performance we could extract from people

.....the next is all about how much humanity we can inspire

Dov Speidman